Summary: Mr X complained the Council reduced the support provided to him through his care plan so was not meeting his eligible care needs. The Council was not at fault.

The complaint

1. Mr X complained the Council reduced the support provided to him through his care plan so was not meeting his eligible care needs. He said this caused him significant distress and impacted on his ability to maintain social relationships and access the community and appointments.

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The Ombudsman’s role and powers

2. We investigate complaints about ‘maladministration’ and ‘service failure’. In this statement, I have used the word ‘fault’ to refer to these. If we are satisfied with an organisation’s actions or proposed actions, we can complete our investigation and issue a decision statement. (Local Government Act 1974, section 30(1B) and 34H(i), as amended)
3. We consider whether there was fault in the way an organisation made its decision. If there was no fault in the decision making, we cannot question the outcome. (Local Government Act 1974, section 34(3), as amended)

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How I considered this complaint

4. I have discussed the complaint with Mr X and considered the information he provided. I have considered the Council’s response to my enquiries and the relevant law and guidance.
5. I gave Mr X and the council the opportunity to comment on a draft of this decision and considered any comments I received in reaching a final decision.

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What I found

The relevant law and guidance

6. Sections 9 and 10 of the Care Act 2014 require councils to carry out an assessment for any adult with an appearance of need for care and support. The assessment must be of the adult’s needs and how they impact on their wellbeing and the results they want to achieve.
7. The Care Act 2014 gives councils a legal responsibility to provide a care and support plan. The care and support plan should consider what needs the person has, what they want to achieve, what they can do by themselves or with existing support and what care and support may be available in the local area.  The support plan must include a personal budget, which is the money the council has worked out it will cost to arrange the necessary care and support for that person.
8. The Care and Support Statutory Guidance sets out that in determining how to meet needs the council may take into reasonable consideration its own finances and budgetary position. This includes the importance of ensuring that the funding available to the council is sufficient to meet the needs of the entire local population.

The Equality Act

9. The Equality Act 2010 provides a legal framework to protect the rights of individuals and advance equality of opportunity for all. It makes it unlawful for organisations carrying out public functions to discriminate on any of the nine protected characteristics listed in the Equality Act 2010. They must also have regard to the general duties aimed at eliminating discrimination under the Public Sector Equality Duty.
10. We cannot decide if an organisation has breached the Equality Act as this can only be done by the courts. But we can make decisions about whether or not an organisation has properly taken account of an individual’s rights in its treatment of them.
11. Organisations will often be able to show they have properly taken account of the Equality Act if they have considered the impact their decisions will have on the individuals affected and these decisions can be challenged, reviewed or appealed.

What happened

12. Mr X has a visual impairment. Since March 2022 Mr X has received support from a care provider with shopping, accessing the community and accessing recreational and educational facilities. He received 6-10 hours of care per week to be used flexibly and a mileage allowance of 160 miles over four weeks plus a 20% mileage contingency should this be required. The support plan stated that any unused mileage could roll over to the next month. The plan stated that it needed to be flexible and adapt depending on the appointments Mr X needed to attend. Mr X also received an allowance for advocacy support. Under risks the plan included that the Council’s Locality Team should be contacted if Mr X did not have sufficient mileage hours if appointments changed.
13. In early September 2022 the care provider contacted the Council. It said Mr X’s choice of trips out meant he used a minimum of 30 miles per visit and so was regularly going over the mileage allowance in his care and support plan. It provided information which showed in August 2022 it had visited Mr X twice a week with details of the trips taken.
14. In mid October 2022 Mr X contacted the Council. He said the care workers had not turned up. When he contacted them he said they reported they had not been paid by the Council so were not attending. The Council confirmed there was no issue with payments to the care provider.
15. In late October 2022 Mr X complained to the Council he was not receiving care. A Council manager spoke to the care provider. They noted it said it was providing support as per the care plan. It said it had pre-warned Mr X, five days before the end of the month, that he only had four miles left of his monthly mileage and so would need to stay locally at their next visit. Mr X disagreed with this. It said Mr X considered this illegal. It said it had visited the previous day but Mr X had said the Council had cancelled his support.
16. Mr X spoke to the Council manager that day. The manager told Mr X his mileage allowance should be adequate for his needs but it could be reviewed. They noted Mr X said if the Council could not accommodate his mileage it could not fulfil his support and had therefore withdrawn his support. The manager suggested it could review Mr X’s support, which he agreed to. Mr X also complained to the Council.
17. In early November the care provider told the Council Mr X had cancelled his care because the care provider refused to provide him with unlimited mileage.
18. The Council spoke to Mr X in mid November. He complained his care package was not fit for purpose. The Council noted Mr X said he might as well not have a care package as the Council was not fulfilling its duties.
19. The Council responded to Mr X’s complaint in early December 2022. It confirmed it had not withdrawn Mr X’s care services, nor had the care provider. It said it had not stopped the payment for mileage. It reiterated that the care provider had spoken to Mr X as he only had a few miles left on his monthly mileage allowance so would need to go out locally. To make sure Mr X’s care plan was meeting his eligible care needs the Council proposed a review of his care plan.
20. A social worker reviewed Mr X’s support plan in early December 2022. The social worker noted that at the review meeting Mr X stated it was unlawful for the Council to cap his mileage allowance. The social worker noted Mr X said he needed to access locations which he knew were accessible and that Mr X stated he had seen his GP four times in the past five weeks which added to the trips and accumulation of mileage. He considered the current mileage allowance was insufficient and wanted the mileage cap removed. Mr X’s care provider also attended the review. It said an increase in mileage would create more flexibility for Mr X in terms of meeting his eligible needs.
21. The Council wrote to Mr X and a council officer also telephoned Mr X in January 2023 to request further information regarding his need to attend appointments and other travel requirements. They noted Mr X said he could not supply any numbers as this tended to be too random. For example they noted he said he had been to hospital three times that week and he considered the Council had a duty to ensure he could attend medical appointments.
22. The social worker was satisfied that Mr X’s existing care package was sufficient to meet his needs. They referred Mr X to an agency that provides support to those who are visually impaired and also made a referral for advocacy support for Mr X as he had requested this during the review meeting. In making the referral the social worker explained to the advocacy service that they had completed a review and at that review Mr X had requested advocacy support. If the advocacy service agreed to support Mr X they would arrange another review.
23. Mr X’s advocate contacted the Council in April 2023 to ask about a care review. The Council confirmed it had reviewed Mr X’s care needs in December 2022 but was willing to carry out another review. The Council advised the advocate that the review in December 2022 did not agree any changes to Mr X’s current care plan. It considered the mileage in the care plan met his assessed area of need and it had not agreed unlimited mileage.
24. In mid-May the advocate advised the Council Mr X had agreed to proceed with a care review meeting.

Findings

25. The Council has a duty to assess an individual’s needs and to provide care and support to meet those needs. The Council did this. Mr X has a care and support plan to provide him with support with shopping, accessing the community and accessing recreational and educational facilities which includes hours of support and a mileage allowance. It was not at fault.
26. Mr X is unhappy with the limit on his mileage budget. The Ombudsman cannot question a council's decision if it is made without fault. The records show Mr X’s mileage allowance allows the care provider to support him to access the community, meet his recreational needs and go shopping. Mr X’s support plan also advises that the Council Locality Team can be contacted if the mileage is not sufficient due to a change in appointments. When Mr X said the mileage was too small, the Council requested further information on Mr X’s medical appointments so it could consider whether to increase his mileage allowance. Mr X could not provide specific evidence. The Council considered Mr X’s views and the information from the care provider and was satisfied the care package was suitable to meet his needs. There was no evidence of fault in the way the Council reviewed Mr X’s care and support needs and set his personal budget so I cannot question its decision not to increase the mileage allowance.
27. Mr X feels the Council has acted unlawfully. I am satisfied the Council gave due regard to its duties under the Equality Act as it considered Mr X’s protected characteristic and his individual circumstances in determining his care and support plan. Mr X requested advocacy support and the Council agreed to this. The Council offered to review Mr X’s needs with the involvement of the advocate and Mr X has now agreed to this. This will provide Mr X with the opportunity to provide further evidence to support his request for an increased mileage allowance.
28. There is no evidence the Council ceased or reduced Mr X’s care package. Mr X chose not to access it when he disagreed with the limit placed on his mileage allowance.

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Final decision

29. I have completed my investigation. On the evidence considered the Council was not at fault.

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Investigator's decision on behalf of the Ombudsman